Advanced Medical-Surgical Nursing Test Bank
Course Introduction
Advanced Medical-Surgical Nursing builds upon foundational nursing knowledge to prepare students for the complex care needs of adult patients with acute and chronic health conditions. The course emphasizes critical thinking, clinical decision-making, and evidence-based interventions for patients experiencing complex medical and surgical issues. Students explore advanced pathophysiology, pharmacological management, and interdisciplinary approaches to care, including preoperative, intraoperative, and postoperative considerations. Emphasis is placed on clinical leadership, patient safety, and quality improvement within acute care settings. Through case studies, simulation, and clinical experiences, students develop competencies required to manage high-risk patient populations and respond to rapidly changing clinical situations.
Recommended Textbook
Medical Surgical Nursing Assessment and Management of Clinical Problems 9th Edition by Lewis
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69 Chapters
2018 Verified Questions
2018 Flashcards
Source URL: https://quizplus.com/study-set/999
Page 2
Chapter 1: Professional Nursing Practice
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/19657
Sample Questions
Q1) The nurse documenting the patient's progress in the care plan in the electronic health record before an interdisciplinary discharge conference is demonstrating competency in which QSEN category?
A) Patient-centered care
B) Quality improvement
C) Evidence-based practice
D) Informatics and technology
Answer: D
Q2) The nurse is caring for an older adult patient who had surgery to repair a fractured hip.The patient needs continued nursing care and physical therapy to improve mobility before returning home.The nurse will help to arrange for transfer of this patient to which facility?
A) A skilled care facility
B) A residential care facility
C) A transitional care facility
D) An intermediate care facility
Answer: C
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Chapter 2: Health Disparities and Culturally Competent Care
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18 Verified Questions
18 Flashcards
Source URL: https://quizplus.com/quiz/19658
Sample Questions
Q1) A Hispanic patient complains of abdominal cramping caused by empacho.Which action should the nurse take first?
A) Ask the patient what treatments are likely to help.
B) Massage the patient's abdomen until the pain is gone.
C) Administer prescribed medications to decrease the cramping.
D) Offer to contact a curandero(a) to make a visit to the patient.
Answer: A
Q2) An older Asian American patient tells the nurse that she has lived in the United States for 50 years.The patient speaks English and lives in a predominantly Asian neighborhood.Which action by the nurse is most appropriate?
A) Include a shaman when planning the patient's care.
B) Avoid direct eye contact with the patient during care.
C) Ask the patient about any special cultural beliefs or practices.
D) Involve the patient's oldest son to assist with health care decisions.
Answer: C
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4
Chapter 3: Health History and Physical Examination
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15 Verified Questions
15 Flashcards
Source URL: https://quizplus.com/quiz/19659
Sample Questions
Q1) During the health history interview,a patient tells the nurse about periodic fainting spells.Which question by the nurse will best elicit any associated clinical manifestations?
A) "How frequently do you have the fainting spells?"
B) "Where are you when you have the fainting spells?"
C) "Do the spells tend to occur at any special time of day?"
D) "Do you have any other symptoms along with the spells?"
Answer: D
Q2) When assessing for formation of a possible blood clot in the lower leg of a patient,which action should the nurse take first?
A) Visually inspect the leg.
B) Feel for the temperature of the leg.
C) Check the patient's pedal pulses using the fingertips.
D) Compress the nail beds to determine capillary refill time.
Answer: A
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Chapter 4: Patient and Caregiver Teaching
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/19660
Sample Questions
Q1) A patient states,"I told my husband I wouldn't buy as much prepared food snacks,so I will go the grocery store to buy fresh fruit,vegetables,and whole grains." When using the Transtheoretical Model of Health Behavior Change,the nurse identifies that this patient is in which stage of change?
A) Preparation
B) Termination
C) Maintenance
D) Contemplation
Q2) A patient with diabetic neuropathy requires teaching about foot care.Which learning goal should the nurse include in the teaching plan?
A) The nurse will demonstrate the proper technique for trimming toenails.
B) The patient will list three ways to protect the feet from injury by discharge.
C) The nurse will instruct the patient on appropriate foot care before discharge.
D) The patient will understand the rationale for proper foot care after instruction.
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Chapter 5: Chronic Illness and Older Adults
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/19661
Sample Questions
Q1) The family of an older patient with chronic health problems and increasing weakness is considering placement in a long-term care (LTC)facility.Which action by the nurse will be most helpful in assisting the patient to make this transition?
A) Have the family select a LTC facility that is relatively new.
B) Obtain the patient's input about the choice of a LTC facility.
C) Ask that the patient be placed in a private room at the facility.
D) Explain the reasons for the need to live in LTC to the patient.
Q2) The nurse plans to complete a thorough assessment of an older patient.Which method should the nurse use to gather the most complete information?
A) Use a geriatric assessment instrument to evaluate the patient.
B) Ask the patient to write down medical problems and medications.
C) Interview both the patient and the primary caregiver for the patient.
D) Review the patient's medical record for a history of medical problems.
Q3) Which patient is most likely to need long-term nursing care management?
A) 72-year-old who had a hip replacement after a fall at home
B) 64-year-old who developed sepsis after a ruptured peptic ulcer
C) 76-year-old who had a cholecystectomy and bile duct drainage
D) 63-year-old with bilateral knee osteoarthritis who weighs 350 lb (159 kg)
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Chapter 6: Complementary and Alternative Therapies
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13 Verified Questions
13 Flashcards
Source URL: https://quizplus.com/quiz/19662
Sample Questions
Q1) Which nursing actions can the registered nurse (RN)delegate to a licensed practical/vocational nurse (LPN/LVN)? ?
A) Ask a newly admitted patient about home use of herbal medications.
B) Administer prescribed naproxen (Naprosyn) to a patient with osteoarthritis.
C) Provide a gentle back rub to a patient who is having difficulty falling asleep.
D) Teach a patient with heart disease about the benefits of fish oil supplements.
E) Evaluate whether home use of aloe has affected a patient's electrolyte levels.
Q2) A patient who uses multiple herbal products is scheduled for knee replacement surgery.Which herbal products should the nurse instruct the patient to discontinue at least 2 to 3 weeks before surgery ?
A) Garlic
B) Ginger
C) Feverfew
D) Echinacea
E) Ginkgo biloba
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Chapter 7: Stress and Stress Management
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12 Verified Questions
12 Flashcards
Source URL: https://quizplus.com/quiz/19663
Sample Questions
Q1) A nurse prepares an adult patient with a severe burn injury for a dressing change.The nurse knows that this is a painful procedure and wants to provide music to help the patient relax.Which action is best for the nurse to take?
A) Use music composed by Mozart.
B) Ask the patient about music preferences.
C) Select music that has 60 to 80 beats/minute.
D) Encourage the patient to use music without words.
Q2) A patient who is hospitalized with a pelvic fracture after a motor vehicle accident just received news that the driver of the car died from multiple injuries.What actions should the nurse take based on knowledge of the physiologic stress reactions that may occur in this patient ?
A) Assess for bradycardia.
B) Ask about epigastric pain.
C) Observe for decreased appetite.
D) Check for elevated blood glucose levels.
E) Monitor for a decrease in respiratory rate.
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Chapter 8: Sleep and Sleep Disorders
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11 Verified Questions
11 Flashcards
Source URL: https://quizplus.com/quiz/19664
Sample Questions
Q1) Which information obtained by the nurse about an older adult who complains of occasional insomnia indicates a need for patient teaching ?
A) Drinks a cup of coffee every morning with breakfast
B) Has a snack every evening 1 hour before going to bed
C) Likes to read or watch television in bed on most evenings
D) Usually takes a warm bath just before bedtime every night
E) Occasionally uses diphenhydramine (Benadryl) as a sleep aid
Q2) Which patient statement indicates a need for further teaching about extended-release zolpidem (Ambien CR)?
A) "I will take the medication an hour before bedtime."
B) "I should take the medication on an empty stomach."
C) "I should not take this medication unless I can sleep for at least 6 hours."
D) "I will schedule activities that require mental alertness for later in the day."
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Chapter 9: Pain
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/19665
Sample Questions
Q1) A nurse assesses a patient with chronic cancer pain who is receiving imipramine (Tofranil)in addition to long-acting morphine.Which statement,if made by the patient,indicates to the nurse that the patient is receiving adequate pain control?
A) "I'm not anxious at all."
B) "I sleep 8 hours every night."
C) "I feel much less depressed since I've been taking the Tofranil."
D) "The pain is manageable and I can accomplish my desired activities.
Q2) Which nursing action could the nurse delegate to unlicensed assistive personnel (UAP)when caring for a patient who is using a fentanyl (Duragesic)patch and a heating pad for treatment of chronic back pain?
A) Check the skin under the heating pad.
B) Take the respiratory rate every 2 hours.
C) Monitor sedation using the sedation assessment scale.
D) Ask the patient about whether pain control is effective.
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11
Chapter 10: Palliative Care at End of Life
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16 Verified Questions
16 Flashcards
Source URL: https://quizplus.com/quiz/19666
Sample Questions
Q1) As the nurse admits a patient in end-stage kidney disease to the hospital,the patient tells the nurse,"If my heart or breathing stop,I do not want to be resuscitated." Which action is best for the nurse to take?
A) Ask if these wishes have been discussed with the health care provider.
B) Place a "Do Not Resuscitate" (DNR) notation in the patient's care plan.
C) Inform the patient that a notarized advance directive must be included in the record or resuscitation must be performed.
D) Advise the patient to designate a person to make health care decisions when the patient is not able to make them independently.
Q2) The nurse cares for an adolescent patient who is dying.The patient's parents are interested in organ donation and ask the nurse how the decision about brain death is made.Which response by the nurse is most appropriate?
A) "Brain death occurs if a person is flaccid and unresponsive."
B) "If CPR is ineffective in restoring a heartbeat, the brain cannot function."
C) "Brain death has occurred if there is no breathing and certain reflexes are absent."
D) "If respiratory efforts cease and no apical pulse is audible, brain death is present."
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Chapter 11: Substance Abuse
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/19667
Sample Questions
Q1) A patient admitted with shortness of breath and chest pain who is a pack-a-day smoker tells the nurse,"I am just not ready to quit smoking yet." Which response by the nurse is best?
A) "This would be a really good time to quit."
B) "Your smoking is the cause of your chest pain."
C) "What health problems do you think smoking has caused?"
D) "Are you familiar with the various nicotine replacement options?"
Q2) After receiving change-of-shift report on four patients who are undergoing substance abuse treatment,which patient will the nurse assess first?
A) A patient who has just arrived for alcohol abuse treatment and states that the last drink was 3 hours ago
B) A patient who is agitated and experiencing nausea, occasional vomiting, and diarrhea while withdrawing from heroin
C) A patient who has tremors secondary to benzodiazepine withdrawal and whose last benzodiazepine use was 4 days ago
D) A patient who is being treated for cocaine addiction and is irritable and disoriented, with a pulse rate of 112 beats/minute
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Chapter 12: Inflammation and Wound Healing
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22 Verified Questions
22 Flashcards
Source URL: https://quizplus.com/quiz/19668
Sample Questions
Q1) A patient who has diabetes is admitted for an exploratory laparotomy for abdominal pain.When planning interventions to promote wound healing,what is the nurse's highest priority?
A) Maintaining the patient's blood glucose within a normal range
B) Ensuring that the patient has an adequate dietary protein intake
C) Giving antipyretics to keep the temperature less than 102° F (38.9° C)
D) Redressing the surgical incision with a dry, sterile dressing twice daily
Q2) The nurse could delegate care of which patient to a licensed practical/vocational nurse (LPN/LVN)?
A) The patient who has increased tenderness and swelling around a leg wound
B) The patient who was just admitted after suturing of a full-thickness arm wound
C) The patient who needs teaching about home care for a draining abdominal wound
D) The patient who requires a hydrocolloid dressing change for a stage III sacral ulcer
Q3) A patient's temperature has been 101° F (38.3° C)for several days.The patient's normal caloric intake to meet nutritional needs is 2000 calories per day.Knowing that the metabolic rate increases 7% for each Fahrenheit degree above 100° in body temperature,how many total calories should the patient receive each day?
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Chapter 13: Genetics and Genomics
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7 Verified Questions
7 Flashcards
Source URL: https://quizplus.com/quiz/19669
Sample Questions
Q1) The sister of a patient diagnosed with BRCA gene-related breast cancer asks the nurse,"Do you think I should be tested for the gene?" Which response by the nurse is most appropriate?
A) "In most cases, breast cancer is not caused by the BRCA gene."
B) "It depends on how you will feel if the test is positive for the BRCA gene."
C) "There are many things to consider before deciding to have genetic testing."
D) "You should decide first whether you are willing to have a bilateral mastectomy."
Q2) A male patient with hemophilia asks the nurse if his children will be hemophiliacs.Which response by the nurse is appropriate?
A) "All of your children will be at risk for hemophilia."
B) "Hemophilia is a multifactorial inherited condition."
C) "Only your male children are at risk for hemophilia."
D) "Your female children will be carriers for hemophilia."
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15
Chapter 14: Altered Immune Responses, and Transplantation
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/19670
Sample Questions
Q1) Which patient should the nurse assess first?
A) Patient with urticaria after receiving an IV antibiotic
B) Patient who has graft-versus-host disease and severe diarrhea
C) Patient who is sneezing after having subcutaneous immunotherapy
D) Patient with multiple chemical sensitivities who has muscle stiffness
Q2) A new mother expresses concern about her baby developing allergies and asks what the health care provider meant by "passive immunity." Which example should the nurse use to explain this type of immunity?
A) Early immunization
B) Bone marrow donation
C) Breastfeeding her infant
D) Exposure to communicable diseases
Q3) A patient is being evaluated for possible atopic dermatitis.The nurse expects elevation of which laboratory value?
A) IgE
B) IgA
C) Basophils
D) Neutrophils
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Chapter 15: Infection and Human Immunodeficiency Virus
Infection
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/19671
Sample Questions
Q1) The nurse will most likely prepare a medication teaching plan about antiretroviral therapy (ART)for which patient?
A) Patient who is currently HIV negative but has unprotected sex with multiple partners
B) Patient who was infected with HIV 15 years ago and now has a CD4<sup>+</sup> count of 840/µL
C) HIV-positive patient with a CD4<sup>+</sup> count of 160/µL who drinks a fifth of whiskey daily
D) Patient who tested positive for HIV 2 years ago and now has cytomegalovirus (CMV) retinitis
Q2) A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS)tells the nurse,"I feel obsessed with thoughts about dying.Do you think I am just being morbid?" Which response by the nurse is best?
A) "Thinking about dying will not improve the course of AIDS."
B) "It is important to focus on the good things about your life now."
C) "Do you think that taking an antidepressant might be helpful to you?"
D) "Can you tell me more about the kind of thoughts that you are having?"
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Page 17
Chapter 16: Cancer
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43 Verified Questions
43 Flashcards
Source URL: https://quizplus.com/quiz/19672
Sample Questions
Q1) A chemotherapy drug that causes alopecia is prescribed for a patient.Which action should the nurse take to maintain the patient's self-esteem?
A) Tell the patient to limit social contacts until regrowth of the hair occurs.
B) Encourage the patient to purchase a wig or hat and wear it once hair loss begins.
C) Teach the patient to gently wash hair with a mild shampoo to minimize hair loss.
D) Inform the patient that hair usually grows back once the chemotherapy is complete.
Q2) The nurse supervises the care of a patient with a temporary radioactive cervical implant.Which action by unlicensed assistive personnel (UAP),if observed by the nurse,would require an intervention?
A) The UAP flushes the toilet once after emptying the patient's bedpan.
B) The UAP stands by the patient's bed for 30 minutes talking with the patient.
C) The UAP places the patient's bedding in the laundry container in the hallway.
D) The UAP gives the patient an alcohol-containing mouthwash to use for oral care.
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18
Chapter 17: Fluid, Electrolyte, and Acid-Base Imbalances
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37 Verified Questions
37 Flashcards
Source URL: https://quizplus.com/quiz/19673
Sample Questions
Q1) An older adult patient who is malnourished presents to the emergency department with a serum protein level of 5.2 g/dL.The nurse would expect which clinical manifestation?
A) Pallor
B) Edema
C) Confusion
D) Restlessness
Q2) The nurse is caring for a patient who has a calcium level of 12.1 mg/dL.Which nursing action should the nurse include on the care plan?
A) Maintain the patient on bed rest.
B) Auscultate lung sounds every 4 hours.
C) Monitor for Trousseau's and Chvostek's signs.
D) Encourage fluid intake up to 4000 mL every day.
Q3) Which action should the nurse take first when a patient complains of acute chest pain and dyspnea soon after insertion of a centrally inserted IV catheter?
A) Notify the health care provider.
B) Offer reassurance to the patient.
C) Auscultate the patient's breath sounds.
D) Give the prescribed PRN morphine sulfate IV.
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Page 19
Chapter 18: Nursing Management: Preoperative Care
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/19674
Sample Questions
Q1) A patient scheduled for an elective hysterectomy tells the nurse,"I am afraid that I will die in surgery like my mother did!" Which response by the nurse is most appropriate?
A) "Tell me more about what happened to your mother."
B) "You will receive medications to reduce your anxiety."
C) "You should talk to the doctor again about the surgery."
D) "Surgical techniques have improved a lot in recent years."
Q2) The outpatient surgery nurse reviews the complete blood cell (CBC)count results for a patient who is scheduled for surgery in a few days.The results are white blood cell (WBC)count 10.2 × 10³/µL; hemoglobin 15 g/dL; hematocrit 45%; platelets 150 × 10³/µL.Which action should the nurse take?
A) Call the surgeon and anesthesiologist immediately.
B) Ask the patient about any symptoms of a recent infection.
C) Discuss the possibility of blood transfusion with the patient.
D) Send the patient to the holding area when the operating room calls.
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Chapter 19: Nursing Management: Intraoperative Care
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18 Verified Questions
18 Flashcards
Source URL: https://quizplus.com/quiz/19675
Sample Questions
Q1) Which action best describes the role of the certified registered nurse anesthetist (CRNA)on the surgical care team?
A) Performs the same responsibilities as the anesthesiologist.
B) Releases or discharges patients from the postanesthesia care area.
C) Administers intraoperative anesthetics ordered by the anesthesiologist.
D) Manages a patient's airway under the direct supervision of the anesthesiologist.
Q2) Monitored anesthesia care (MAC)is going to be used for a closed,manual reduction of a dislocated shoulder.What action does the nurse anticipate?
A) Securing an airtight fit for the inhalation mask
B) Starting a 20-gauge IV in the patient's unaffected arm
C) Obtaining a nonocclusive dressing to place over the administration site
D) Teaching the patient about epidural patient-controlled anesthesia (PCA) use
Q3) Which action will the nurse take immediately after surgery for a patient who received ketamine (Ketalar)as an anesthetic agent?
A) Administer higher doses of analgesic agents.
B) Ensure that atropine is available in case of bradycardia.
C) Question the order for benzodiazepines to be administered.
D) Provide a quiet environment in the postanesthesia care unit.
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Chapter 20: Nursing Management: Postoperative Care
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/19676
Sample Questions
Q1) An older patient is being discharged from the ambulatory surgical unit following left eye surgery.The patient tells the nurse,"I do not know if I can take care of myself with this patch over my eye." Which action by the nurse is most appropriate?
A) Refer the patient for home health care services.
B) Discuss the specific concerns regarding self-care.
C) Give the patient written instructions regarding care.
D) Assess the patient's support system for care at home.
Q2) Which action could the postanesthesia care unit (PACU)nurse delegate to unlicensed assistive personnel (UAP)who help with the transfer of a patient to the clinical unit?
A) Clarify the postoperative orders with the surgeon.
B) Help with the transfer of the patient onto a stretcher.
C) Document the appearance of the patient's incision in the chart.
D) Provide hand off communication to the surgical unit charge nurse.
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Chapter 21: Nursing Assessment: Visual and Auditory Systems
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/19677
Sample Questions
Q1) Which information will the nurse provide to the patient scheduled for refractometry?
A) "You will need to wear sunglasses for a few hours after the exam."
B) "The surface of your eye will be numb while the doctor does the exam."
C) "You should not take any of your eye medicines before the examination."
D) "The doctor will shine a bright light into your eye during the examination."
Q2) The nurse recording health histories in the outpatient clinic would plan a focused hearing assessment for adult patients taking which medication?
A) Atenolol (Tenormin) taken to prevent angina
B) Acetaminophen (Tylenol) taken frequently for headaches
C) Ibuprofen (Advil) taken for 20 years to treat osteoarthritis
D) Albuterol (Proventil) taken since childhood to treat asthma
Q3) When obtaining a health history from a 49-year-old patient,which patient statement is most important to communicate to the primary health care provider?
A) "My eyes are dry now."
B) "It is hard for me to see at night."
C) "My vision is blurry when I read."
D) "I can't see as far over to the side."
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Page 23
Chapter 22: Nursing Management: Visual and Auditory
Problems
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47 Verified Questions
47 Flashcards
Source URL: https://quizplus.com/quiz/19678
Sample Questions
Q1) Unlicensed assistive personnel (UAP)perform all the following actions when caring for a patient with Ménière's disease who is experiencing an acute attack.Which action by UAP indicates that the nurse should intervene immediately?
A) UAP raise the side rails on the bed.
B) UAP turn on the patient's television.
C) UAP turn the patient to the right side.
D) UAP place an emesis basin at the bedside.
Q2) A patient who received a corneal transplant 2 weeks ago calls the ophthalmology clinic to report that his vision has not improved with the transplant.Which action should the nurse take?
A) Suggest the patient arrange a ride to the clinic immediately.
B) Ask about the presence of "floaters" in the patient's visual field.
C) Remind the patient it may take months to restore vision after transplant.
D) Teach the patient to continue using prescribed pupil-dilating medications.
Q3) A patient who has undergone a left tympanoplasty should be instructed to A) remain on bed rest.
B) keep the head elevated.
C) avoid blowing the nose.
D) irrigate the left ear canal.
Page 24
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Chapter 23: Nursing Assessment: Integumentary System
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13 Verified Questions
13 Flashcards
Source URL: https://quizplus.com/quiz/19679
Sample Questions
Q1) Which integumentary assessment data from an older patient admitted with bacterial pneumonia is of most concern for the nurse?
A) Reports a history of allergic rashes
B) Scattered macular brown areas on extremities
C) Skin brown and wrinkled, skin tenting on forearm
D) Longitudinal nail bed ridges noted; sparse scalp hair
Q2) The nurse assesses a circular,flat,reddened lesion about 5 cm in diameter on a middle-aged patient's ankle.How should the nurse determine if the lesion is related to intradermal bleeding?
A) Elevate the patient's leg.
B) Press firmly on the lesion.
C) Check the temperature of the skin around the lesion.
D) Palpate the dorsalis pedis and posterior tibial pulses.
Q3) A dark-skinned patient has been admitted to the hospital with chronic heart failure.How would the nurse best assess this patient for cyanosis?
A) Assess the skin color of the earlobes.
B) Apply pressure to the palms of the hands.
C) Check the lips and oral mucous membranes.
D) Examine capillary refill time of the nail beds.
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Page 25
Chapter 24: Nursing Management: Integumentary
Problems
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/19680
Sample Questions
Q1) Which information should the nurse include when teaching patients about decreasing the risk for sun damage to the skin?
A) Use a sunscreen with an SPF of at least 8 to 10 for adequate protection.
B) Water resistant sunscreens will provide good protection when swimming.
C) Increase sun exposure by no more than 10 minutes a day to avoid skin damage.
D) Try to stay out of the sun between the hours of 10 AM and 2 PM (regular time).
Q2) An older adult patient with a squamous cell carcinoma (SCC)on the lower arm has a Mohs procedure in the dermatology clinic.Which nursing action will be included in the postoperative plan of care?
A) Describe the use of topical fluorouracil on the incision.
B) Teach how to use sterile technique to clean the suture line.
C) Schedule daily appointments for wet-to-dry dressing changes.
D) Teach about the use of cold packs to reduce bruising and swelling.
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Chapter 25: Nursing Management: Burns
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/19681
Sample Questions
Q1) A patient has just arrived in the emergency department after an electrical burn from exposure to a high-voltage current.What is the priority nursing assessment?
A) Oral temperature
B) Peripheral pulses
C) Extremity movement
D) Pupil reaction to light
Q2) An 80-kg patient with burns over 30% of total body surface area (TBSA)is admitted to the burn unit.Using the Parkland formula of 4 mL/kg/%TBSA,what is the IV infusion rate (mL/hour)for lactated Ringer's solution that the nurse will administer during the first 8 hours?
Q3) Eight hours after a thermal burn covering 50% of a patient's total body surface area (TBSA)the nurse assesses the patient.Which information would be a priority to communicate to the health care provider?
A) Blood pressure is 95/48 per arterial line.
B) Serous exudate is leaking from the burns.
C) Cardiac monitor shows a pulse rate of 108.
D) Urine output is 20 mL per hour for the past 2 hours.
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Page 27
Chapter 26: Nursing Assessment: Respiratory System
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24 Verified Questions
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Sample Questions
Q1) While listening to the posterior chest of a patient who is experiencing acute shortness of breath,the nurse hears these sounds.How should the nurse document the lung sounds?
A) Pleural friction rub
B) Low-pitched crackles
C) High-pitched wheezes
D) Bronchial breath sounds
Q2) When assessing the respiratory system of an older patient,which finding indicates that the nurse should take immediate action?
A) Weak cough effort
B) Barrel-shaped chest
C) Dry mucous membranes
D) Bilateral crackles at lung bases
Q3) A patient with acute shortness of breath is admitted to the hospital.Which action should the nurse take during the initial assessment of the patient?
A) Ask the patient to lie down to complete a full physical assessment.
B) Briefly ask specific questions about this episode of respiratory distress.
C) Complete the admission database to check for allergies before treatment.
D) Delay the physical assessment to first complete pulmonary function tests.
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Page 28
Chapter 27: Nursing Management: Upper Respiratory
Problems
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/19683
Sample Questions
Q1) The nurse is caring for a mechanically ventilated patient with a cuffed tracheostomy tube.Which action by the nurse would best determine if the cuff has been properly inflated?
A) Use a manometer to ensure cuff pressure is at an appropriate level.
B) Check the amount of cuff pressure ordered by the health care provider.
C) Suction the patient first with a fenestrated inner cannula to clear secretions.
D) Insert the decannulation plug before the nonfenestrated inner cannula is removed.
Q2) Which action should the nurse take first when a patient develops a nosebleed?
A) Pinch the lower portion of the nose for 10 minutes.
B) Pack the affected nare tightly with an epistaxis balloon.
C) Obtain silver nitrate that will be needed for cauterization.
D) Apply ice compresses over the patient's nose and cheeks.
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Chapter 28: Nursing Management: Lower Respiratory Problems
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51 Verified Questions
51 Flashcards
Source URL: https://quizplus.com/quiz/19684
Sample Questions
Q1) Which factors will the nurse consider when calculating the CURB-65 score for a patient with pneumonia ?
A) Age
B) Blood pressure
C) Respiratory rate
D) Oxygen saturation
E) Presence of confusion
F) Blood urea nitrogen (BUN) level
Q2) The nurse cares for a patient who has just had a thoracentesis.Which assessment information obtained by the nurse is a priority to communicate to the health care provider?
A) Oxygen saturation is 88%.
B) Blood pressure is 145/90 mm Hg.
C) Respiratory rate is 22 breaths/minute when lying flat.
D) Pain level is 5 (on 0 to 10 scale) with a deep breath.
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Chapter 29: Nursing Management: Obstructive Pulmonary Diseases
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44 Verified Questions
44 Flashcards
Source URL: https://quizplus.com/quiz/19685
Sample Questions
Q1) The nurse is admitting a patient diagnosed with an acute exacerbation of chronic obstructive pulmonary disease (COPD).What is the best way for the nurse to determine the appropriate oxygen flow rate?
A) Minimize oxygen use to avoid oxygen dependency.
B) Maintain the pulse oximetry level at 90% or greater.
C) Administer oxygen according to the patient's level of dyspnea.
D) Avoid administration of oxygen at a rate of more than 2 L/minute.
Q2) The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD).Which information obtained from the patient would prompt the nurse to consult with the health care provider before administering the prescribed theophylline?
A) The patient reports a recent 15-pound weight gain.
B) The patient denies any shortness of breath at present.
C) The patient takes cimetidine (Tagamet) 150 mg daily.
D) The patient complains about coughing up green mucus.
Q3) A patient with asthma has a personal best peak expiratory flow rate (PEFR)of 400 L/minute.When explaining the asthma action plan,the nurse will teach the patient that a change in therapy is needed when the PEFR is less than ___ L/minute
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Page 31
Chapter 30: Nursing Assessment: Hematologic System
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16 Verified Questions
16 Flashcards
Source URL: https://quizplus.com/quiz/19686
Sample Questions
Q1) A patient with pancytopenia of unknown origin is scheduled for the following diagnostic tests.The nurse will provide a consent form to sign for which test?
A) ABO blood typing
B) Bone marrow biopsy
C) Abdominal ultrasound
D) Complete blood count (CBC)
Q2) The health care provider's progress note for a patient states that the complete blood count (CBC)shows a "shift to the left." Which assessment finding will the nurse expect?
A) Cool extremities
B) Pallor and weakness
C) Elevated temperature
D) Low oxygen saturation
Q3) The complete blood count (CBC)indicates that a patient is thrombocytopenic.Which action should the nurse include in the plan of care?
A) Avoid intramuscular injections.
B) Encourage increased oral fluids.
C) Check temperature every 4 hours.
D) Increase intake of iron-rich foods.
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Chapter 31: Nursing Management: Hematologic Problems
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48 Verified Questions
48 Flashcards
Source URL: https://quizplus.com/quiz/19687
Sample Questions
Q1) A postoperative patient receiving a transfusion of packed red blood cells develops chills,fever,headache,and anxiety 35 minutes after the transfusion is started.After stopping the transfusion,what action should the nurse take?
A) Draw blood for a new crossmatch.
B) Send a urine specimen to the laboratory.
C) Administer PRN acetaminophen (Tylenol).
D) Give the PRN diphenhydramine (Benadryl).
Q2) The nurse notes scleral jaundice in a patient being admitted with hemolytic anemia.The nurse will plan to check the laboratory results for the
A) Schilling test.
B) bilirubin level.
C) stool occult blood test.
D) gastric analysis testing.
Q3) Which action will the nurse include in the plan of care for a patient who has thalassemia major?
A) Teach the patient to use iron supplements.
B) Avoid the use of intramuscular injections.
C) Administer iron chelation therapy as needed.
D) Notify health care provider of hemoglobin 11g/dL.
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Page 33
Chapter 32: Nursing Assessment: Cardiovascular System
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) When reviewing the 12-lead electrocardiograph (ECG)for a healthy 79-year-old patient who is having an annual physical examination,what will be of most concern to the nurse?
A) The PR interval is 0.21 seconds.
B) The QRS duration is 0.13 seconds.
C) There is a right bundle-branch block.
D) The heart rate (HR) is 42 beats/minute.
Q2) While doing the admission assessment for a thin 76-year-old patient,the nurse observes pulsation of the abdominal aorta in the epigastric area.Which action should the nurse take?
A) Teach the patient about aneurysms.
B) Notify the hospital rapid response team.
C) Instruct the patient to remain on bed rest.
D) Document the finding in the patient chart.
Q3) The nurse teaches the patient being evaluated for rhythm disturbances with a Holter monitor to
A) connect the recorder to a computer once daily.
B) exercise more than usual while the monitor is in place.
C) remove the electrodes when taking a shower or tub bath.
D) keep a diary of daily activities while the monitor is worn.
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Chapter 33: Nursing Management: Hypertension
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/19689
Sample Questions
Q1) A patient with hypertension who has just started taking atenolol (Tenormin)returns to the health clinic after 2 weeks for a follow-up visit.The blood pressure (BP)is unchanged from the previous visit.Which action should the nurse take first?
A) Inform the patient about the reasons for a possible change in drug dosage.
B) Question the patient about whether the medication is actually being taken.
C) Inform the patient that multiple drugs are often needed to treat hypertension.
D) Question the patient regarding any lifestyle changes made to help control BP.
Q2) After the nurse teaches the patient with stage 1 hypertension about diet modifications that should be implemented,which diet choice indicates that the teaching has been effective?
A) The patient avoids eating nuts or nut butters.
B) The patient restricts intake of chicken and fish.
C) The patient has two cups of coffee in the morning.
D) The patient has a glass of low-fat milk with each meal.
Q3) The nurse obtains a blood pressure of 176/83 mm Hg for a patient.What is the patient's mean arterial pressure (MAP)?
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Page 35
Chapter 34: Nursing Management: Coronary Artery Disease and
Acute Coronary Syndrome
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43 Verified Questions
43 Flashcards
Source URL: https://quizplus.com/quiz/19690
Sample Questions
Q1) Which patient at the cardiovascular clinic requires the most immediate action by the nurse?
A) Patient with type 2 diabetes whose current blood glucose level is 145 mg/dL
B) Patient with stable angina whose chest pain has recently increased in frequency
C) Patient with familial hypercholesterolemia and a total cholesterol of 465 mg/dL
D) Patient with chronic hypertension whose blood pressure today is 172/98 mm Hg
Q2) A patient is recovering from a myocardial infarction (MI)and develops chest pain on day 3 that increases when taking a deep breath and is relieved by leaning forward.Which action should the nurse take next?
A) Assess the feet for pedal edema.
B) Palpate the radial pulses bilaterally.
C) Auscultate for a pericardial friction rub.
D) Check the heart monitor for dysrhythmias.
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Chapter 35: Nursing Management: Heart Failure
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) While admitting an 82-year-old with acute decompensated heart failure to the hospital,the nurse learns that the patient lives alone and sometimes confuses the "water pill" with the "heart pill." When planning for the patient's discharge the nurse will facilitate a
A) consult with a psychologist.
B) transfer to a long-term care facility.
C) referral to a home health care agency.
D) arrangements for around-the-clock care.
Q2) A patient in the intensive care unit with acute decompensated heart failure (ADHF)complains of severe dyspnea and is anxious,tachypneic,and tachycardic.All of the following medications have been ordered for the patient.The nurse's priority action will be to
A) give IV morphine sulfate 4 mg.
B) give IV diazepam (Valium) 2.5 mg.
C) increase nitroglycerin (Tridil) infusion by 5 mcg/min.
D) increase dopamine (Intropin) infusion by 2 mcg/kg/min.
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Chapter 36: Nursing Management: Dysrhythmias
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31 Verified Questions
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Sample Questions
Q1) A patient who is on the progressive care unit develops atrial flutter,rate 150,with associated dyspnea and chest pain.Which action that is included in the hospital dysrhythmia protocol should the nurse do first?
A) Obtain a 12-lead electrocardiogram (ECG).
B) Notify the health care provider of the change in rhythm.
C) Give supplemental O<sub>2</sub> at 2 to 3 L/min via nasal cannula.
D) Assess the patient's vital signs including oxygen saturation.
Q2) A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been unresponsive to drug therapy for several days.The priority teaching needed for this patient would include information about A) anticoagulant therapy.
B) permanent pacemakers.
C) electrical cardioversion.
D) IV adenosine (Adenocard).
Q3) When analyzing an electrocardiographic (ECG)rhythm strip of a patient with a regular heart rhythm,the nurse counts 30 small blocks from one R wave to the next.The nurse calculates the patient's heart rate as ____.
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Page 38
Chapter 37: Nursing Management: Inflammatory and Structural
Heart Disorders
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/19693
Sample Questions
Q1) To assess the patient with pericarditis for evidence of a pericardial friction rub,the nurse should
A) listen for a rumbling, low-pitched, systolic murmur over the left anterior chest.
B) auscultate by placing the diaphragm of the stethoscope on the lower left sternal border.
C) ask the patient to cough during auscultation to distinguish the sound from a pleural friction rub.
D) feel the precordial area with the palm of the hand to detect vibrations with cardiac contraction.
Q2) A patient with rheumatic fever has subcutaneous nodules,erythema marginatum,and polyarthritis.Based on these findings,which nursing diagnosis would be most appropriate?
A) Pain related to permanent joint fixation
B) Activity intolerance related to arthralgia
C) Risk for infection related to open skin lesions
D) Risk for impaired skin integrity related to pruritus
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Chapter 38: Nursing Management: Vascular Disorders
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/19694
Sample Questions
Q1) A patient has a 6-cm thoracic aortic aneurysm that was discovered during a routine chest x-ray.When obtaining an admission history from the patient,it will be most important for the nurse to ask about
A) low back pain.
B) trouble swallowing.
C) abdominal tenderness.
D) changes in bowel habits.
Q2) When assessing a patient with possible peripheral artery disease (PAD),the nurse obtains a brachial BP of 147/82 and an ankle pressure of 112/74.The nurse calculates the patient's ankle-brachial index (ABI)as ________ (round up to the nearest hundredth).
Q3) When developing a teaching plan for a 76-year-old patient newly diagnosed with peripheral artery disease (PAD),which instructions should the nurse include?
A) "Exercise only if you do not experience any pain."
B) "It is very important that you stop smoking cigarettes."
C) "Try to keep your legs elevated whenever you are sitting."
D) "Put elastic compression stockings on early in the morning."
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Chapter 39: Nursing Assessment: Gastrointestinal System
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18 Verified Questions
18 Flashcards
Source URL: https://quizplus.com/quiz/19695
Sample Questions
Q1) A 58-year-old woman has just returned to the nursing unit after an esophagogastroduodenoscopy (EGD).Which action by unlicensed assistive personnel (UAP)requires that the registered nurse (RN)intervene?
A) Offering the patient a drink of water
B) Positioning the patient on the right side
C) Checking the vital signs every 30 minutes
D) Swabbing the patient's mouth with cold water
Q2) A 54-year-old man has just arrived in the recovery area after an upper endoscopy.Which information collected by the nurse is most important to communicate to the health care provider?
A) The patient is very drowsy.
B) The patient reports a sore throat.
C) The oral temperature is 101.6° F.
D) The apical pulse is 104 beats/minute.
Q3) After assisting with a needle biopsy of the liver at a patient's bedside,the nurse should
A) put pressure on the biopsy site using a sandbag.
B) elevate the head of the bed to facilitate breathing.
C) place the patient on the right side with the bed flat.
D) check the patient's postbiopsy coagulation studies.
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Chapter 40: Nursing Management: Nutritional Problems
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24 Verified Questions
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Sample Questions
Q1) After abdominal surgery,a patient with protein calorie malnutrition is receiving parenteral nutrition (PN).Which is the best indicator that the patient is receiving adequate nutrition?
A) Serum albumin level is 3.5 mg/dL.
B) Fluid intake and output are balanced.
C) Surgical incision is healing normally.
D) Blood glucose is less than 110 mg/dL.
Q2) A malnourished patient is receiving a parenteral nutrition (PN)infusion containing amino acids and dextrose from a bag that was hung 24 hours ago.The nurse observes that about 50 mL remain in the PN container.Which action is best for the nurse to take?
A) Ask the health care provider to clarify the written PN order.
B) Add a new container of PN using the current tubing and filter.
C) Hang a new container of PN and change the IV tubing and filter.
D) Infuse the remaining 50 mL and then hang a new container of PN.
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Chapter 41: Nursing Management: Obesity
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Sample Questions
Q1) Which assessment action will help the nurse determine if an obese patient has metabolic syndrome?
A) Take the patient's apical pulse.
B) Check the patient's blood pressure.
C) Ask the patient about dietary intake.
D) Dipstick the patient's urine for protein.
Q2) Which finding for a patient who has been taking orlistat (Xenical)is most important to report to the health care provider?
A) The patient frequently has liquid stools.
B) The patient is pale and has many bruises.
C) The patient complains of bloating after meals.
D) The patient is experiencing a weight loss plateau.
Q3) The nurse is caring for a 54-year-old female patient on the first postoperative day after a Roux-en-Y gastric bypass procedure.Which assessment finding should be reported immediately to the surgeon?
A) Bilateral crackles audible at both lung bases
B) Redness, irritation, and skin breakdown in skinfolds
C) Emesis of bile-colored fluid past the nasogastric (NG) tube
D) Use of patient-controlled analgesia (PCA) several times an hour for pain
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Page 43
Chapter 42: Nursing Management: Upper Gastrointestinal
Problems
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47 Verified Questions
47 Flashcards
Source URL: https://quizplus.com/quiz/19698
Sample Questions
Q1) Which nursing action should be included in the postoperative plan of care for a patient after a laparoscopic esophagectomy?
A) Notify the doctor about bloody nasogastric (NG) drainage.
B) Elevate the head of the bed to at least 30 degrees.
C) Reposition the NG tube if drainage stops.
D) Start oral fluids when the patient has active bowel sounds.
Q2) A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG)tube in place.When the patient develops sudden,severe upper abdominal pain,diaphoresis,and a firm abdomen,which action should the nurse take?
A) Irrigate the NG tube.
B) Check the vital signs.
C) Give the ordered antacid.
D) Elevate the foot of the bed.
Q3) Which information about dietary management should the nurse include when teaching a patient with peptic ulcer disease (PUD)?
A) "You will need to remain on a bland diet."
B) "Avoid foods that cause pain after you eat them."
C) "High-protein foods are least likely to cause you pain."
D) "You should avoid eating any raw fruits and vegetables."
Page 44
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Chapter 43: Nursing Management: Lower Gastrointestinal
Problems
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56 Verified Questions
56 Flashcards
Source URL: https://quizplus.com/quiz/19699
Sample Questions
Q1) A 62-year-old patient has had a hemorrhoidectomy at an outpatient surgical center.Which instructions will the nurse include in discharge teaching?
A) Maintain a low-residue diet until the surgical area is healed.
B) Use ice packs on the perianal area to relieve pain and swelling.
C) Take prescribed pain medications before a bowel movement is expected.
D) Delay having a bowel movement for several days until healing has occurred.
Q2) A 50-year-old female patient calls the clinic to report a new onset of severe diarrhea.The nurse anticipates that the patient will need to
A) collect a stool specimen.
B) prepare for colonoscopy.
C) schedule a barium enema.
D) have blood cultures drawn.
Q3) Which question from the nurse would help determine if a patient's abdominal pain might indicate irritable bowel syndrome?
A) "Have you been passing a lot of gas?"
B) "What foods affect your bowel patterns?"
C) "Do you have any abdominal distention?"
D) "How long have you had abdominal pain?"
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Chapter 44: Nursing Management:
Biliary Tract Problems
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46 Verified Questions
46 Flashcards
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Sample Questions
Q1) A 51-year-old woman had an incisional cholecystectomy 6 hours ago.The nurse will place the highest priority on assisting the patient to
A) choose low-fat foods from the menu.
B) perform leg exercises hourly while awake.
C) ambulate the evening of the operative day.
D) turn, cough, and deep breathe every 2 hours.
Q2) A 23-year-old has been admitted with acute liver failure.Which assessment data are most important for the nurse to communicate to the health care provider?
A) Asterixis and lethargy
B) Jaundiced sclera and skin
C) Elevated total bilirubin level
D) Liver 3 cm below costal margin
Q3) To prepare a 56-year-old male patient with ascites for paracentesis,the nurse
A) places the patient on NPO status.
B) assists the patient to lie flat in bed.
C) asks the patient to empty the bladder.
D) positions the patient on the right side.
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Page 46
Chapter 45: Nursing Assessment: Urinary System
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/19701
Sample Questions
Q1) The nurse assessing the urinary system of a 45-year-old female would use auscultation to
A) determine kidney position.
B) identify renal artery bruits.
C) check for ureteral peristalsis.
D) assess for bladder distention.
Q2) A male patient in the clinic provides a urine sample that is red-orange in color.Which action should the nurse take first?
A) Notify the patient's health care provider.
B) Teach correct midstream urine collection.
C) Ask the patient about current medications.
D) Question the patient about urinary tract infection (UTI) risk factors.
Q3) Which nursing action is essential for a patient immediately after a renal biopsy?
A) Check blood glucose to assess for hyperglycemia or hypoglycemia.
B) Insert a urinary catheter and test urine for gross or microscopic hematuria.
C) Monitor the blood urea nitrogen (BUN) and creatinine to assess renal function.
D) Apply a pressure dressing and keep the patient on the affected side for 30 minutes.
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Page 47
Chapter 46: Nursing Management: Renal and Urologic Problems
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45 Verified Questions
45 Flashcards
Source URL: https://quizplus.com/quiz/19702
Sample Questions
Q1) Nursing staff on a hospital unit are reviewing rates of hospital-acquired infections (HAI)of the urinary tract.Which nursing action will be most helpful in decreasing the risk for HAI in patients admitted to the hospital?
A) Encouraging adequate oral fluid intake
B) Testing urine with a dipstick daily for nitrites
C) Avoiding unnecessary urinary catheterizations
D) Providing frequent perineal hygiene to patients
Q2) A 63-year-old male patient had a cystectomy with an ileal conduit yesterday.Which new assessment data is most important for the nurse to communicate to the physician?
A) Cloudy appearing urine
B) Hypotonic bowel sounds
C) Heart rate 102 beats/minute
D) Continuous stoma drainage
Q3) The nurse teaches a 64-year-old woman to prevent the recurrence of renal calculi by
A) using a filter to strain all urine.
B) avoiding dietary sources of calcium.
C) choosing diuretic fluids such as coffee.
D) drinking 2000 to 3000 mL of fluid a day.
Page 48
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Chapter 47: Nursing Management: Acute Kidney Injury and Chronic Kidney Disease
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39 Verified Questions
39 Flashcards
Source URL: https://quizplus.com/quiz/19703
Sample Questions
Q1) Before administration of calcium carbonate (Caltrate)to a patient with chronic kidney disease (CKD),the nurse should check laboratory results for A) potassium level.
B) total cholesterol.
C) serum phosphate.
D) serum creatinine.
Q2) A patient with diabetes who has bacterial pneumonia is being treated with IV gentamicin (Garamycin)60 mg IV BID.The nurse will monitor for adverse effects of the medication by evaluating the patient's
A) blood glucose.
B) urine osmolality.
C) serum creatinine.
D) serum potassium.
Q3) During routine hemodialysis,the 68-year-old patient complains of nausea and dizziness.Which action should the nurse take first?
A) Slow down the rate of dialysis.
B) Check patient's blood pressure (BP).
C) Review the hematocrit (Hct) level.
D) Give prescribed PRN antiemetic drugs.
Page 49
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Chapter 48: Nursing Assessment: Endocrine System
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22 Verified Questions
22 Flashcards
Source URL: https://quizplus.com/quiz/19704
Sample Questions
Q1) Which action by a new registered nurse (RN)caring for a patient with a goiter and possible hyperthyroidism indicates that the charge nurse needs to do more teaching?
A) The RN checks the blood pressure on both arms.
B) The RN palpates the neck thoroughly to check thyroid size.
C) The RN lowers the thermostat to decrease the temperature in the room.
D) The RN orders nonmedicated eye drops to lubricate the patient's bulging eyes.
Q2) A 60-year-old patient is taking spironolactone (Aldactone),a drug that blocks the action of aldosterone on the kidney,for hypertension.The nurse will monitor for
A) increased serum sodium.
B) decreased urinary output.
C) elevated serum potassium.
D) evidence of fluid overload.
Q3) A nurse will teach a patient who is scheduled to complete a 24-hour urine collection for 17-ketosteroids to
A) insert and maintain a retention catheter.
B) keep the specimen refrigerated or on ice.
C) drink at least 3 L of fluid during the 24 hours.
D) void and save that specimen to start the collection.
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Chapter 49: Nursing Management: Diabetes Mellitus
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49 Verified Questions
49 Flashcards
Source URL: https://quizplus.com/quiz/19705
Sample Questions
Q1) An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic.Which finding may indicate the need for a change in therapy?
A) Hemoglobin A?C level 6.2%
B) Blood pressure 146/88 mmHg
C) Heart rate at rest 58 beats/minute
D) High density lipoprotein (HDL) level 65 mg/dL
Q2) Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage)?
A) The patient's blood glucose level is 174 mg/dL.
B) The patient has gained 2 lb (0.9 kg) since yesterday.
C) The patient is scheduled for a chest x-ray in an hour.
D) The patient's blood urea nitrogen (BUN) level is 52 mg/dL.
Q3) A 55-year-old female patient with type 2 diabetes has a nursing diagnosis of imbalanced nutrition: more than body requirements.Which goal is most important for this patient?
A) The patient will reach a glycosylated hemoglobin level of less than 7%.
B) The patient will follow a diet and exercise plan that results in weight loss.
C) The patient will choose a diet that distributes calories throughout the day.
D) The patient will state the reasons for eliminating simple sugars in the diet.
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Page 51
Chapter 50: Nursing Management: Endocrine Problems
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46 Verified Questions
46 Flashcards
Source URL: https://quizplus.com/quiz/19706
Sample Questions
Q1) A patient has just arrived on the unit after a thyroidectomy.Which action should the nurse take first?
A) Observe the dressing for bleeding.
B) Check the blood pressure and pulse.
C) Assess the patient's respiratory effort.
D) Support the patient's head with pillows.
Q2) A 38-year-old male patient is admitted to the hospital in Addisonian crisis.Which patient statement supports a nursing diagnosis of ineffective self-health management related to lack of knowledge about management of Addison's disease?
A) "I frequently eat at restaurants, and my food has a lot of added salt."
B) "I had the stomach flu earlier this week, so I couldn't take the hydrocortisone."
C) "I always double my dose of hydrocortisone on the days that I go for a long run."
D) "I take twice as much hydrocortisone in the morning dose as I do in the afternoon."
Q3) A patient is to receive methylprednisolone (Solu-Medrol)100 mg.The label on the medication states: methylprednisolone 125 mg in 2 mL.How many milliliters will the nurse administer?
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Chapter 51: Nursing Assessment: Reproductive System
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/19707
Sample Questions
Q1) After scheduling a patient with a possible ovarian cyst for ultrasound,the nurse will teach the patient that she should
A) expect to receive IV contrast during the procedure.
B) drink several glasses of fluids before the procedure.
C) experience mild abdominal cramps after the procedure.
D) discontinue taking aspirin for 7 days before the procedure.
Q2) The nurse will plan to teach a 51-year-old man who is scheduled for an annual physical exam about a(n)
A) increased risk for testicular cancer.
B) possible changes in erectile function.
C) normal decreases in testosterone level.
D) prostate specific antigen (PSA) testing.
Q3) The nurse is providing teaching by telephone to a patient who is scheduled for a pelvic examination and Pap test next week.The nurse instructs the patient that she should
A) shower, but not take a tub bath, before the examination.
B) not have sexual intercourse the day before the Pap test.
C) avoid douching for at least 24 hours before the examination.
D) schedule to have the Pap test just after her menstrual period.
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Page 53
Chapter 52: Nursing Management: Breast Disorders
Available Study Resources on Quizplus for this Chatper
28 Verified Questions
28 Flashcards
Source URL: https://quizplus.com/quiz/19708
Sample Questions
Q1) A student nurse prepares a list of teaching topics for a patient with a new diagnosis of breast cancer.Which item should the charge nurse suggest that the student nurse omit from the teaching topic list about breast cancer diagnostic testing?
A) CA 15-3 level testing
B) HER-2 receptor testing
C) Estrogen receptor testing
D) Oncotype DX assay testing
Q2) A 58-year-old woman tells the nurse,"I understand that I have stage II breast cancer and I need to decide on a surgery,but I feel overwhelmed.What do you think I should do?"
Which response by the nurse is best?
A) "I would have a lumpectomy, but you need to decide what is best for you."
B) "Tell me what you understand about the surgical options that are available."
C) "It would not be appropriate for me to make a decision about your health."
D) "There is no need to make a decision rapidly; you have time to think about this."
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Chapter 53: Nursing Management: Sexually Transmitted
Infections
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/19709
Sample Questions
Q1) A 29-year-old female patient is diagnosed with Chlamydia during a routine pelvic examination.The nurse knows that teaching regarding the management of the condition has been effective when the patient says which of the following?
A) "My partner will need to take antibiotics at the same time I do."
B) "Go ahead and give me the antibiotic injection, so I will be cured."
C) "I will use condoms during sex until I finish taking all the antibiotics."
D) "I do not plan on having children, so treating the infection is not important."
Q2) A 46-year-old man who has had blood drawn for an insurance screening has a positive Venereal Disease Research Laboratory (VDRL)test.Which action should the nurse take next?
A) Ask the patient about past treatment for syphilis.
B) Explain the need for blood and spinal fluid cultures.
C) Obtain a specimen for fluorescent treponemal antibody absorption (FAT-Abs) testing.
D) Assess for the presence of chancres, flulike symptoms, or a bilateral rash on the trunk.
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Chapter 54: Nursing Management: Female Reproductive Problems
Available Study Resources on Quizplus for this Chatper
49 Verified Questions
49 Flashcards
Source URL: https://quizplus.com/quiz/19710
Sample Questions
Q1) A 34-year-old woman who is discussing contraceptive options with the nurse says,"I want to have children,but not for a few years." Which response by the nurse is appropriate?
A) "If you do not become pregnant within the next few years, you never will."
B) "You may have more difficulty becoming pregnant after about age 35."
C) "You have many years of fertility left, so there is no rush to have children."
D) "You should plan to stop taking oral contraceptives several years before you want to become pregnant."
Q2) A 56-year-old woman is concerned about having a moderate amount of vaginal bleeding after 4 years of menopause.The nurse will anticipate teaching the patient about
A) endometrial biopsy.
B) endometrial ablation.
C) uterine balloon therapy.
D) dilation and curettage (D&C).
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Chapter 55: Nursing Management: Male Reproductive Problems
Available Study Resources on Quizplus for this Chatper
35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/19711
Sample Questions
Q1) When obtaining the pertinent health history for a man who is being evaluated for infertility,which question is most important for the nurse to ask?
A) "Are you circumcised?"
B) "Have you had surgery for phimosis?"
C) "Do you use medications to improve muscle mass?"
D) "Is there a history of prostate cancer in your family?"
Q2) A 71-year-old patient who has benign prostatic hyperplasia (BPH)with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN)and creatinine.Which prescribed therapy should the nurse implement first?
A) Infuse normal saline at 50 mL/hr.
B) Insert a urinary retention catheter.
C) Draw blood for a complete blood count.
D) Schedule a pelvic computed tomography (CT) scan.
Q3) The nurse will plan to teach the patient scheduled for photovaporization of the prostate (PVP)
A) that urine will appear bloody for several days.
B) how to care for an indwelling urinary catheter.
C) that symptom improvement takes 2 to 3 weeks.
D) about complications associated with urethral stenting.
Page 57
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Chapter 56: Nursing Assessment: Nervous System
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/19712
Sample Questions
Q1) Which finding would the nurse expect when assessing the legs of a patient who has a lower motor neuron lesion?
A) Spasticity
B) Flaccidity
C) No sensation
D) Hyperactive reflexes
Q2) Which equipment will the nurse obtain to assess vibration sense in a diabetic patient who has peripheral nerve dysfunction?
A) Sharp pin
B) Tuning fork
C) Reflex hammer
D) Calibrated compass
Q3) Which action will the nurse include in the plan of care for a patient with impaired functioning of the left glossopharyngeal nerve (CN IX)and the vagus nerve (CN X)?
A) Withhold oral fluid or foods.
B) Provide highly seasoned foods.
C) Insert an oropharyngeal airway.
D) Apply artificial tears every hour.
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Chapter 57: Nursing Management: Acute Intracranial Problems
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40 Verified Questions
40 Flashcards
Source URL: https://quizplus.com/quiz/19713
Sample Questions
Q1) When admitting a 42-year-old patient with a possible brain injury after a car accident to the emergency department (ED),the nurse obtains the following information.Which finding is most important to report to the health care provider?
A) The patient takes warfarin (Coumadin) daily.
B) The patient's blood pressure is 162/94 mm Hg.
C) The patient is unable to remember the accident.
D) The patient complains of a severe dull headache.
Q2) Which patient is most appropriate for the intensive care unit (ICU)charge nurse to assign to a registered nurse (RN)who has floated from the medical unit?
A) A 45-year-old receiving IV antibiotics for meningococcal meningitis
B) A 25-year-old admitted with a skull fracture and craniotomy the previous day
C) A 55-year-old who has increased intracranial pressure (ICP) and is receiving hyperventilation therapy
D) A 35-year-old with ICP monitoring after a head injury last week
Q3) An unconscious patient with a traumatic head injury has a blood pressure of 130/76 mm Hg,and an intracranial pressure (ICP)of 20 mm Hg.The nurse will calculate the cerebral perfusion pressure (CPP)as ____ mm Hg.
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Page 59
Chapter 58: Nursing Management: Stroke
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/19714
Sample Questions
Q1) When teaching about clopidogrel (Plavix),the nurse will tell the patient with cerebral atherosclerosis
A) to monitor and record the blood pressure daily.
B) that Plavix will dissolve clots in the cerebral arteries.
C) that Plavix will reduce cerebral artery plaque formation.
D) to call the health care provider if stools are bloody or tarry.
Q2) A 63-year-old patient who began experiencing right arm and leg weakness is admitted to the emergency department.In which order will the nurse implement these actions included in the stroke protocol? (Put a comma and a space between each answer choice [A,B,C,D].)
A) Obtain computed tomography (CT) scan without contrast.
B) Infuse tissue plasminogen activator (tPA).
C) Administer oxygen to keep O<sub>2</sub> saturation >95%.
D) Use National Institute of Health Stroke Scale to assess patient.
Q3) A 58-year-old patient with a left-brain stroke suddenly bursts into tears when family members visit.The nurse should
A) use a calm voice to ask the patient to stop the crying behavior.
B) explain to the family that depression is normal following a stroke.
C) have the family members leave the patient alone for a few minutes.
D) teach the family that emotional outbursts are common after strokes.
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Chapter 59: Nursing Management: Chronic Neurologic Problems
Available Study Resources on Quizplus for this Chatper
36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/19715
Sample Questions
Q1) A hospitalized 31-year-old patient with a history of cluster headache awakens during the night with a severe stabbing headache.Which action should the nurse take first?
A) Start the ordered PRN oxygen at 6 L/min.
B) Put a moist hot pack on the patient's neck.
C) Give the ordered PRN acetaminophen (Tylenol).
D) Notify the patient's health care provider immediately.
Q2) A 31-year-old woman who has multiple sclerosis (MS)asks the nurse about risks associated with pregnancy.Which response by the nurse is accurate?
A) "MS symptoms may be worse after the pregnancy."
B) "Women with MS frequently have premature labor."
C) "MS is associated with an increased risk for congenital defects."
D) "Symptoms of MS are likely to become worse during pregnancy."
Q3) Which action will the nurse plan to take for a 40-year-old patient with multiple sclerosis (MS)who has urinary retention caused by a flaccid bladder?
A) Decrease the patient's evening fluid intake.
B) Teach the patient how to use the Credé method.
C) Suggest the use of adult incontinence briefs for nighttime only.
D) Assist the patient to the commode every 2 hours during the day.
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Chapter 60: Nursing Management: Alzheimer's
Disease,Dementia,and Delirium
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/19716
Sample Questions
Q1) The nurse is concerned about a postoperative patient's risk for injury during an episode of delirium.The most appropriate action by the nurse is to
A) secure the patient in bed using a soft chest restraint.
B) ask the health care provider to order an antipsychotic drug.
C) instruct family members to remain with the patient and prevent injury.
D) assign unlicensed assistive personnel (UAP) to stay with the patient and offer reorientation.
Q2) Which hospitalized patient will the nurse assign to the room closest to the nurses' station?
A) Patient with Alzheimer's disease who has long-term memory deficit
B) Patient with vascular dementia who takes medications for depression
C) Patient with new-onset confusion, restlessness, and irritability after surgery
D) Patient with dementia who has an abnormal Mini-Mental State Examination
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Chapter 61: Nursing Management: Peripheral Nerve and Spinal Cord Problems
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33 Verified Questions
33 Flashcards
Source URL: https://quizplus.com/quiz/19717
Sample Questions
Q1) Before administering botulinum antitoxin to a patient in the emergency department,it is most important for the nurse to
A) obtain the patient's temperature.
B) administer an intradermal test dose.
C) document the neurologic symptoms.
D) ask the patient about an allergy to eggs.
Q2) A patient with neurogenic shock following a spinal cord injury is to receive lactated Ringer's solution 500 mL over 30 minutes.When setting the IV pump to deliver the IV fluid,the nurse will set the rate at how many mL/hour?
Q3) Which action will the nurse take when caring for a 46-year-old patient who develops tetanus from an injectable substance use?
A) Avoid use of sedatives.
B) Provide a quiet environment.
C) Check pupil reaction to light every 4 hours.
D) Provide range-of-motion exercises several times daily.
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Chapter 62: Nursing Assessment: Musculoskeletal System
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15 Verified Questions
15 Flashcards
Source URL: https://quizplus.com/quiz/19718
Sample Questions
Q1) Which finding is of highest priority when the nurse is planning care for a 77-year-old patient seen in the outpatient clinic?
A) Symmetric joint swelling of fingers
B) Decreased right knee range of motion
C) Report of left hip aching when jogging
D) History of recent loss of balance and fall
Q2) Which information in a 67-year-old woman's health history will alert the nurse to the need for a more focused assessment of the musculoskeletal system?
A) The patient sprained her ankle at age 13.
B) The patient's mother became shorter with aging.
C) The patient takes ibuprofen (Advil) for occasional headaches.
D) The patient's father died of complications of miliary tuberculosis.
Q3) A patient with left knee pain is diagnosed with bursitis.The nurse will explain that bursitis is an inflammation of
A) the synovial membrane that lines the joint.
B) a small, fluid-filled sac found at some joints.
C) the fibrocartilage that acts as a shock absorber in the knee joint.
D) any connective tissue that is found supporting the joints of the body.
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64
Chapter 63: Nursing Management: Musculoskeletal
Trauma and Orthopedic Surgery
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47 Verified Questions
47 Flashcards
Source URL: https://quizplus.com/quiz/19719
Sample Questions
Q1) When giving home care instructions to a patient who has comminuted forearm fractures and a long-arm cast on the left arm,which information should the nurse include?
A) Keep the left shoulder elevated on a pillow or cushion.
B) Keep the hand immobile to prevent soft tissue swelling.
C) Call the health care provider for increased swelling or numbness of the hand.
D) Avoid nonsteroidal antiinflammatory drugs (NSAIDs) for 24 hours after the injury.
Q2) A patient has a long-arm plaster cast applied for immobilization of a fractured left radius.Until the cast has completely dried,the nurse should
A) keep the left arm in dependent position.
B) avoid handling the cast using fingertips.
C) place gauze around the cast edge to pad any roughness.
D) cover the cast with a small blanket to absorb the dampness.
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Chapter 64: Nursing Management: Musculoskeletal
Problems
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/19720
Sample Questions
Q1) Which information will the nurse include when teaching a patient with acute low back pain ?
A) Sleep in a prone position with the legs extended.
B) Keep the knees straight when leaning forward to pick something up.
C) Avoid activities that require twisting of the back or prolonged sitting.
D) Symptoms of acute low back pain frequently improve in a few weeks.
E) Ibuprofen (Motrin, Advil) or acetaminophen (Tylenol) can be used to relieve pain.
Q2) A 23-year-old patient with a history of muscular dystrophy is hospitalized with pneumonia.Which nursing action will be included in the plan of care?
A) Logroll the patient every 2 hours.
B) Assist the patient with ambulation.
C) Discuss the need for genetic testing with the patient.
D) Teach the patient about the muscle biopsy procedure.
Q3) Which action will the nurse take when caring for a patient with osteomalacia?
A) Teach about the use of vitamin D supplements.
B) Educate about the need for weight-bearing exercise.
C) Discuss the use of medications such as bisphosphonates.
D) Emphasize the importance of sunscreen use when outside.
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Chapter 65: Nursing Management: Arthritis and Connective
Tissue Diseases
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47 Verified Questions
47 Flashcards
Source URL: https://quizplus.com/quiz/19721
Sample Questions
Q1) A 71-year-old patient who takes multiple medications develops acute gouty arthritis.The nurse will consult with the health care provider before giving the prescribed dose of
A) sertraline (Zoloft).
B) famotidine (Pepcid).
C) oxycodone (Roxicodone).
D) hydrochlorothiazide (HydroDIURIL).
Q2) The nurse will anticipate the need to teach a 57-year-old patient who has osteoarthritis (OA)about which medication?
A) Adalimumab (Humira)
B) Prednisone (Deltasone)
C) Capsaicin cream (Zostrix)
D) Sulfasalazine (Azulfidine)
Q3) Which finding for a patient who is taking hydroxychloroquine (Plaquenil)to treat rheumatoid arthritis is likely to be an adverse effect of the medication?
A) Blurred vision
B) Joint tenderness
C) Abdominal cramping
D) Elevated blood pressure
Page 67
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Chapter 66: Nursing Management: Critical Care
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41 Verified Questions
41 Flashcards
Source URL: https://quizplus.com/quiz/19722
Sample Questions
Q1) An 81-year-old patient who has been in the intensive care unit (ICU)for a week is now stable and transfer to the progressive care unit is planned.On rounds,the nurse notices that the patient has new onset confusion.The nurse will plan to
A) give PRN lorazepam (Ativan) and cancel the transfer.
B) inform the receiving nurse and then transfer the patient.
C) notify the health care provider and postpone the transfer.
D) obtain an order for restraints as needed and transfer the patient.
Q2) When assisting with the placement of a pulmonary artery (PA)catheter,the nurse notes that the catheter is correctly placed when the monitor shows a
A) typical PA pressure waveform.
B) tracing of the systemic arterial pressure.
C) tracing of the systemic vascular resistance.
D) typical PA wedge pressure (PAWP) tracing.
Q3) A patient's vital signs are pulse 87,respirations 24,and BP of 128/64 mm Hg and cardiac output is 4.7 L/min.The patient's stroke volume is _____ mL.(Round to the nearest whole number.)
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Chapter 67: Nursing Management: Shock, Systemic
Inflammatory Response Syndrome, and Multiple Organ
Dysfunction Syndrome
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29 Verified Questions
29 Flashcards
Source URL: https://quizplus.com/quiz/19723
Sample Questions
Q1) A patient who has been involved in a motor vehicle crash arrives in the emergency department (ED)with cool,clammy skin; tachycardia; and hypotension.Which intervention ordered by the health care provider should the nurse implement first?
A) Insert two large-bore IV catheters.
B) Initiate continuous electrocardiogram (ECG) monitoring.
C) Provide oxygen at 100% per non-rebreather mask.
D) Draw blood to type and crossmatch for transfusions.
Q2) The emergency department (ED)nurse receives report that a patient involved in a motor vehicle crash is being transported to the facility with an estimated arrival in 1 minute.In preparation for the patient's arrival,the nurse will obtain
A) hypothermia blanket.
B) lactated Ringer's solution.
C) two 14-gauge IV catheters.
D) dopamine (Intropin) infusion.
Q3) A 198-lb patient is to receive a dobutamine infusion at 5 mcg/kg/minute.The label on the infusion bag states: dobutamine 250 mg in 250 mL normal saline.When setting the infusion pump,the nurse will set the infusion rate at how many mL per hour?
Page 69
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Chapter 68: Nursing Management: Respiratory Failure and
Acute Respiratory Distress Syndrome
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27 Verified Questions
27 Flashcards
Source URL: https://quizplus.com/quiz/19724
Sample Questions
Q1) After receiving change-of-shift report on a medical unit,which patient should the nurse assess first?
A) A patient with cystic fibrosis who has thick, green-colored sputum
B) A patient with pneumonia who has crackles bilaterally in the lung bases
C) A patient with emphysema who has an oxygen saturation of 90% to 92%
D) A patient with septicemia who has intercostal and suprasternal retractions
Q2) A patient with acute respiratory distress syndrome (ARDS)and acute kidney injury has the following medications ordered.Which medication should the nurse discuss with the health care provider before giving?
A) Pantoprazole (Protonix) 40 mg IV
B) Gentamicin (Garamycin) 60 mg IV
C) Sucralfate (Carafate) 1 g per nasogastric tube
D) Methylprednisolone (Solu-Medrol) 60 mg IV
Q3) When assessing a patient with chronic obstructive pulmonary disease (COPD),the nurse finds a new onset of agitation and confusion.Which action should the nurse take first?
A) Notify the health care provider.
B) Check pupils for reaction to light.
C) Attempt to calm and reorient the patient.
D) Assess oxygenation using pulse oximetry.
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Available Study Resources on Quizplus for this Chatper
26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/19725
Sample Questions
Q1) The emergency department (ED)nurse is initiating therapeutic hypothermia in a patient who has been resuscitated after a cardiac arrest.Which actions in the hypothermia protocol can be delegated to an experienced licensed practical/vocational nurse (LPN/LVN)?
A) Continuously monitor heart rhythm.
B) Check neurologic status every 2 hours.
C) Place cooling blankets above and below patient.
D) Give acetaminophen (Tylenol) 650 mg per nasogastric tube.
E) Insert rectal temperature probe and attach to cooling blanket control panel.
Q2) A 19-year-old is brought to the emergency department (ED)with multiple lacerations and tissue avulsion of the left hand.When asked about tetanus immunization,the patient denies having any previous vaccinations.The nurse will anticipate giving
A) tetanus immunoglobulin (TIG) only.
B) TIG and tetanus-diphtheria toxoid (Td).
C) tetanus-diphtheria toxoid and pertussis vaccine (Tdap) only.
D) TIG and tetanus-diphtheria toxoid and pertussis vaccine (Tdap).
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